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Treatment[edit]

A number of psychotherapy approaches have been designed with the treatment of trauma in mind—EMDR, progressive counting (PC), somatic experiencing, biofeedback, Internal Family Systems Therapy, and sensorimotor psychotherapy.

There is a large body of empirical support for the use of cognitive behavioral therapy[1][2] for the treatment of trauma-related symptoms,[3] including post-traumatic stress disorder. Institute of Medicine guidelines identify cognitive behavioral therapies as the most effective treatments for PTSD.[4] Two of these cognitive behavioral therapies, prolonged exposure[5] and cognitive processing therapy,[6] are being disseminated nationally by the Department of Veterans Affairs for the treatment of PTSD.[7][8] Seeking Safety is another type of cognitive behavioral therapy that focuses on learning safe coping skills for co-occurring PTSD and substance use problems.[9] While some sources highlight Seeking Safety as effective[10] with strong research support,[11] others have suggested that it did not lead to improvements beyond usual treatment.[9]

Recent studies show that a combination of treatments involving dialectical behavior therapy (DBT), often used for borderline personality disorder, and exposure therapy is highly effective in treating psychological trauma.[12] If, however, psychological trauma has caused dissociative disorders or complex PTSD, the trauma model approach (also known as phase-oriented treatment of structural dissociation) has been proven to work better than simple cognitive approach. Studies funded by pharmaceuticals have also shown that medications such as the new anti-depressants are effective when used in combination with other psychological approaches.[13]

Trauma therapy allows processing trauma-related memories and allows growth towards more adaptive psychological functioning. It helps to develop positive coping instead of negative coping and allows the individual to integrate upsetting-distressing material (thoughts, feelings and memories) and to resolve these internally. It also aids in growth of personal skills like resilience, ego regulation, empathy, etc.[14]

Processes involved in trauma therapy are:

  • Psychoeducation: Information dissemination and educating in vulnerabilities and adoptable coping mechanisms.
  • Emotional regulation: Identifying, countering discriminating, grounding thoughts and emotions from internal construction to an external representation.
  • Cognitive processing: Transforming negative perceptions and beliefs about self, others and environment to positive ones through cognitive reconsideration or re-framing.
  • Trauma processing: Systematic desensitization, response activation and counter-conditioning, titrated extinction of emotional response, deconstructing disparity (emotional vs. reality state), resolution of traumatic material (in theory, to a state in which triggers no longer produce harmful distress and the individual is able to express relief.)
  • Emotional processing: Reconstructing perceptions, beliefs and erroneous expectations, habituating new life contexts for auto-activated trauma-related fears, and providing crisis cards with coded emotions and appropriate cognitions. (This stage is only initiated in pre-termination phase from clinical assessment and judgement of the mental health professional.)
  • Experiential processing: Visualization of achieved relief state and relaxation methods.

A number of complementary approaches to trauma treatment have been implicated as well, including yoga and meditation.[15] As an integrative treatment, yoga increases coping skills that focus on being in the present moment [16]. Yoga can reduce worry, anxiety, and avoidance through present focused breathing and concentration techniques we well as advancing acceptance and nonjudgmental thoughts and behaviors [17]. Similarly, meditation promotes mental focus through various meditative approaches, including mindfulness meditation, mantra meditation, and compassion meditation [18].

  1. ^ "What is Cognitive Behavior Therapy (CBT)?". Association for Behavioral and Cognitive Therapies.
  2. ^ Schnurr, PP.; Friedman, MJ.; Engel, CC.; Foa, EB.; Shea, MT.; Chow, BK.; Resick, PA.; Thurston, V.; et al. (Feb 2007). "Cognitive behavioral therapy for posttraumatic stress disorder in women: a randomized controlled trial". JAMA. 297 (8): 820–30. doi:10.1001/jama.297.8.820. PMID 17327524.
  3. ^ "ABCT Fact Sheets: Trauma". Association for Behavioral and Cognitive Therapies.
  4. ^ Institute of Medicine (2008). Treatment of posttraumatic stress disorder: An assessment of the evidence. Washington, DC: The National Academies Press.
  5. ^ McLean, CP.; Foa, EB. (Aug 2011). "Prolonged exposure therapy for post-traumatic stress disorder: a review of evidence and dissemination". Expert Rev Neurother. 11 (8): 1151–63. doi:10.1586/ern.11.94. PMID 21797656.
  6. ^ Resick, PA.; Galovski, TE.; O'Brien Uhlmansiek, M.; Scher, CD.; Clum, GA.; Young-Xu, Y. (Apr 2008). "A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence". J Consult Clin Psychol. 76 (2): 243–58. doi:10.1037/0022-006X.76.2.243. PMC 2967760. PMID 18377121.
  7. ^ Hamblen, Schnurr; Rosenberg, MA; Eftekhari. "Overview of Psychotherapy for PTSD". U.S. Department of Veterans Affairs. {{cite web}}: Unknown parameter |lastauthoramp= ignored (|name-list-style= suggested) (help)
  8. ^ Karlin, BE.; Ruzek, JI.; Chard, KM.; Eftekhari, A.; Monson, CM.; Hembree, EA.; Resick, PA.; Foa, EB. (Dec 2010). "Dissemination of evidence-based psychological treatments for posttraumatic stress disorder in the Veterans Health Administration". J Trauma Stress. 23 (6): 663–73. doi:10.1002/jts.20588. PMID 21171126.
  9. ^ a b Roberts, Neil P.; Roberts, Pamela A.; Jones, Neil; Bisson, Jonathan I. (2015). "Psychological interventions for post-traumatic stress disorder and comorbid substance use disorder: A systematic review and meta-analysis". Clinical Psychology Review. 38: 25–38. doi:10.1016/j.cpr.2015.02.007. ISSN 0272-7358.
  10. ^ Lenz, A. Stephen; Henesy, Rachel; Callender, Karisse (2016). "Effectiveness of Seeking Safety for Co-Occurring Posttraumatic Stress Disorder and Substance Use". Journal of Counseling & Development. 94 (1): 51–61. doi:10.1002/jcad.12061. ISSN 0748-9633.
  11. ^ "Seeking Safety for PTSD with Substance Use Disorder | Society of Clinical Psychology". www.div12.org. Retrieved 2018-09-26.
  12. ^ Frommberger, Ulrich (2014). "Post-Traumatic Stress Disorder – a Diagnostic and Therapeutic Challenge". Deutsches Arzteblatt International.
  13. ^ Steele K, van der Hart O, Nijenhuis ER (2005). "Phase-oriented treatment of structural dissociation in complex traumatization: overcoming trauma-related phobias". Journal of Trauma & Dissociation. 6 (3): 11–53. CiteSeerX 10.1.1.130.8227. doi:10.1300/J229v06n03_02. PMID 16172081.
  14. ^ Briere, John N.; Scott, Catherine (25 March 2014). Principles of Trauma Therapy: A Guide to Symptoms, Evaluation, and Treatment (DSM-5 Update). SAGE Publications. ISBN 9781483351254 – via Google Books.
  15. ^ Pradhan, Basant; Kluewer D’Amico, Jessica; Makani, Ramkrishna; Parikh, Tapan (2015-07-10). "Nonconventional interventions for chronic post-traumatic stress disorder: Ketamine, repetitive trans-cranial magnetic stimulation (rTMS), and alternative approaches". Journal of Trauma & Dissociation. 17 (1): 35–54. doi:10.1080/15299732.2015.1046101. ISSN 1529-9732.
  16. ^ "International Journal of Yoga Therapy/Yoga Therapy Today -". doi:10.17761/ijyt.22.1.v71h07m12412k218. {{cite journal}}: Cite journal requires |journal= (help); line feed character in |title= at position 57 (help)
  17. ^ "International Journal of Yoga Therapy/Yoga Therapy Today -". doi:10.17761/ijyt.22.1.v71h07m12412k218. {{cite journal}}: Cite journal requires |journal= (help); line feed character in |title= at position 57 (help)
  18. ^ Lang, Ariel J.; Strauss, Jennifer L.; Bomyea, Jessica; Bormann, Jill E.; Hickman, Steven D.; Good, Raquel C.; Essex, Michael (2012-06-05). "The Theoretical and Empirical Basis for Meditation as an Intervention for PTSD". Behavior Modification. 36 (6): 759–786. doi:10.1177/0145445512441200. ISSN 0145-4455.
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